Sometimes, it is not the worker's compensation insurer that denies your claim, but your employer. Here are several reasons your employer may dispute your worker's compensation claim:
Your Injury Never Happened At Work
An employer who doesn't believe that your injury took place in the workplace will dispute your claim. An employer is likely to suspect that your injuries occurred outside the workplace if you don't report your injury immediately, don't have witnesses, and don't have pictures of the accident scene. An employer may also hold that opinion if they have rumors of an accident you incurred elsewhere.
Consider an example where you come to work on a Monday with a broken wrist, and the grapevine has it that you were engaged in a drunken brawl over the weekend. In such a case, the employer they aren't likely to believe that you injured your wrist at work on Friday and waited until Monday to report it.
You Are Feigning Injuries
It's unfortunate that worker's compensation fraud exists; it makes it difficult for those with genuine claims to find fast relief. An employer who suspects your claim to be fraudulent is likely to reject it. An employer is likely to suspect you of making a fraudulent claim if you have a soft tissue, internal, or emotional injury. This is because hard injuries are usually clearly visible and difficult to dispute. For example, it's difficult to accuse you of feigning an injury if you have a fractured limb but not if you have stress.
You Were Intoxicated At the Time of Your Injury
Lastly, your employer may also dispute your claim if they suspect that you were intoxicated at the time of your injury. This is a valid dispute since most states have worker's compensation laws that deny benefits to employees who are injured while intoxicated. The presumption here is that the intoxication impaired your mind and physical balance, leading to or contributing to your injury.
Consider a situation where you slip and fall on a factory floor, dislocating your elbow. If the first responders find a flask of liquor in your back pocket, the employer will assume you are intoxicated. In such a case, the employer will order an alcohol test and deny your claim if it returns positive.
Whenever an employer disputes your claim, the onus is on you to prove them wrong and get your benefits. The first step towards that achievement is to consult a worker's compensation lawyer to review and prove your case. Contact a firm like Vandeventer Black LLP for more information.